Rotator Cuff Repair Post-Operative Protocol

Please call us at (719) 822-6277 
for an appointment.

Christopher Jones, MD

The outline below is meant for patients recovering from surgery for Rotator Cuff Repair. Details and steps can change depending on your situation.

PHASE I – 0-6 Weeks Post-Op

  • No active ROM of the shoulder girdle
  • Remain in sling
  • **6 weeks is the crucial healing period**
  • Scapular elevation, depression, protraction, retraction (e.g. “scapular clocks”)
  • Pendulums with emphasis on “relaxed” shoulder and using the trunk as prime moving force
  • Elbow, wrist, hand motion with the elbow at side
  • Cryotherapy prn

PHASE II – 7-12 Weeks Post-Op

  • Full ROM (Target to achieve full ROM by 12 weeks)
  • Begin dry land active ROM without weight in biomechanically correct ROM only
  • Discontinue sling
  • Glenohumeral and Scapulothoracic joint mobilizations
  • PROM (Target to achieve full ROM by 12 weeks)
  • Minimal manual resistance for isometric ER and IR and rhythmic stabilization (flexion, extension, Horizontal ab/adduction) at 45°-90°-120° elevation in the scapular plane as patient gains control of the upper extremity
  • AARON progressing to minimal manual resistance for PNF patterns
  • Aquatic Therapy – Increase speed of movement for increased resistance as tolerated, progress to using hands as a “paddle” and then to webbed gloves for increased resistance as tolerated. Also add periscapular strengthening (i.e. wall push-ups, supine scapular retraction while floating)
  • Begin dry land active ROM without weights. Must be in good biomechanical ROM. Add light resistance as the patient gains control of the movement with good biomechanics.
  • Include these exercises:
    • Elevation in the scapular plane (initially supine, progress to inclined, then upright)
    • Prone Rowing
    • Serratus “punches” supine
    • Sidelying ER
    • Progress to IR on light pulleys or Theraband (after 6 weeks post-op only)
  • As in Phase I, progress PROM as tolerated to full ROM
  • All AROM exercises and isometrics. Again, emphasize proper biomechanics.

PHASE III – 13+ Weeks Post-Op

  • Return to functional activities
  • Begin a strengthening program
  • G-H joint mobilizations and PROM when indicated
  • Progress exercises in Phase II with increased weight based on 3 sets of 12-15 reps
  • Gradually add the following exercises and progress weights:
    • Periscapular strengthening (wall push-ups, upright rowing, etc.)
    • ER, IR, and PNF patterns on pulleys
    • ER, IR, at 90° abduction
    • Begin functional progression for sports/activity-specific tasks
    • Begin isokinetic for ER, IR at 12 weeks post-op (Begin in modified abduction, progress to supine or sitting 90° abduction position)
  • Maintain PROM
  • Light Theraband exercise of ER, IR, Elevation, and “Full can” on non-PT days
  • Progress to independent strengthening program prior to discharge

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